Sample Record for 2026-02-25-8
Note: Fields with no data or with a value of "Unknown" will not be displayed on the print out.
Project Information
Project ID: 1001824 DEA: 061J3104 EFIS: 0626000064
QA Service Level: 1
DIST-CO-RTE-PM: 06-KER-204-5.9/5.9
Work Description: Calloway Canal bridge repair at Bridge No. 50 0209
Location Description: Replacement of existing barrier rail and sidewalk on WB direction, demo and reconstruct overhang, remove existing AC overlay (2-ft wide from curb), strengthen deck with carbon fiber reinforced polymer bar, place AC overlay, and install new barrier rail.
Contractor Name: Bugler Construction (Kevin Hoffert)
Contractor Address: 4847 Hopyard Rd, Suite 4 #395, Pleasanton, CA 94588
Resident Engineer: Vanessa Valdez Structure Rep.: Vicente Sanchez
Sample Information
DIME Sample ID: 2026-02-25-8
TL Number from the TL Form:
Sample Submitted By Organization: CT HQ - QASI Sacramento Field Office
Sample Organization Contact: (916) 2058871
Type of Sample: Quality Assurance
Type of Material: SMTL TM3 - Fastener Assembly
Sample Taken Date: 02/25/2026
Date that the sample was received by the laboratory/organization performing the testing: 03/02/2026
The quantity of what the sample constitutes: 1 lot of 7
A brief description of the sample: ASTM 1554 GR 105 All Thread Rod
From where was the sample collected: Other
Laboratory sample identification:
Structure unique identifier: 50-0209
Structure name: Calloway Canal Bridge
The fabricator/manufacturer/facility name: C & K Johnson Ind.
Material Information
Rocap Number(s): N/A
Heat Number(s): 10907530
8000035506
190156048
Nut Mfg. Lot Number(s): W000270556
Washer Mfg. Lot Number(s): 0925-789
Bolt Specification: ASTM F1554, Grade 105
Bolt Length(s): 9-3/4"
Nut Specification: ASTM F563, Grade DH
Washer Specification: ASTM F436
Finish: ASTM A153/F2329 - Hot Dip
Diameter/Size: 7/8"
Bolt Mfg. Lot Number: 4870230
Rocap Test Requirement(s): None
Lubricant Requirements(s): None
Washer Inner Diameter(s): NA
Test Results
Test 1 of 1
DIME Test ID: 2026-02-25-8-1
Test Method: ASME B1.2-83r17: (Pitch Diameter) Gages and Gaging for Unified Inch Screw Threads - Errata May 1992 (Pitch Diameter)
Submitted By Organization: CT HQ - Sacramento Structural Materials Testing Laboratory
Organization Address: 5900 Folsom Boulevard,
Organization City: Sacramento
Organization State: CA
Organization Zipcode: 95819
Organization Email: brian.ellis@dot.ca.gov
Organization Phone: (916) 380-8623
Data has not been verified.
